Provider Demographics
NPI:1558559013
Name:ESPINETA, CHRISTINA EVERSWICK (PAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:EVERSWICK
Last Name:ESPINETA
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2612
Practice Address - Street 1:11181 HEALTH PARK BLVD STE 3000
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5743
Practice Address - Country:US
Practice Address - Phone:239-566-1888
Practice Address - Fax:239-430-5559
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9104322363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292930900Medicaid
FLPA9104322OtherMEDICAL LICENSE
P00685855Medicare PIN